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18F-FDG PET/CT in a recurrent diffuse malignant peritoneal mesothelioma
Qi Cao1, Minh Lu, Jonathon Heath
1Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Abstract:
Peritoneal mesothelioma is a rare and aggressive tumor. Early diagnosis of the disease is difficult, delaying effective treatment. We report a case of recurrent, biphasic, diffuse, malignant peritoneal mesothelioma. Initial abdominal computed tomography showed abnormal but nonspecific findings suggestive of an ovarian malignancy, with a negative endoscopy and laboratory studies. An abdominal exploratory laparotomy found widespread malignancy within the peritoneum with a pathological diagnosis of peritoneal mesothelioma. A PET/CT imaging showed diffusely increased metabolic activity throughout the peritoneum, with no evidence of thoracic or pleural involvement. This case demonstrates the PET/CT findings seen with malignant recurrent peritoneal mesothelioma.
Insights
Diagnosing recurrent malignant peritoneal mesothelioma is challenging. Positron emission tomography/computed tomography (PET/CT) imaging effectively identified diffuse peritoneal metabolic activity, aiding diagnosis in this rare cancer.
Area of Science:
- Oncology
- Radiology
- Pathology
Background:
- Peritoneal mesothelioma is a rare, aggressive malignancy.
- Early diagnosis is often delayed due to nonspecific initial findings.
Observation:
- A case of recurrent, biphasic, diffuse, malignant peritoneal mesothelioma presented with nonspecific abdominal CT findings.
- Endoscopy and laboratory studies were negative, complicating initial assessment.
Findings:
- Exploratory laparotomy confirmed widespread peritoneal malignancy.
- PET/CT imaging revealed diffuse increased metabolic activity throughout the peritoneum.
- PET/CT showed no evidence of thoracic or pleural involvement.
Implications:
- This case highlights the utility of PET/CT in diagnosing recurrent malignant peritoneal mesothelioma.
- PET/CT can identify characteristic metabolic patterns in the peritoneum.
- Accurate diagnosis is crucial for timely and effective treatment of peritoneal mesothelioma.
